So positive airway pressure is better than
oxygen when people stop breathing? Imagine
that! Is that maybe why we give breaths in
CPR, rather than simply slapping on a
nasal cannula and calling it good? How
much money was wasted on this "research?"
The other researchers STILL confuse
correlation with causation. Obesity
doesn't cause OSA. OSA causes obesity..

Fran Evans,RRT,RST,CPFT,RPSGT,

06/12/14

We have been saying this for years, CPAP OPENS AIRWAY to restore breathing ( it treats the problem ) Oxygen, while better than nothing , only provides help when patient decides when to breathe again. ( I equate it to placing a bandaid on a gaping wound that needs stitches). It is easier to prescribe oxygen than actually spend the time required to help a person understand and tolerate CPAP, which can be very frustrating and time consuming. We began a CPAP clinic last year within our practice with amazing results. Patients compliance has improved dramatically, they are happier, losing weight, and with improved Symptoms of their daytime sleepiness (which makes their partners happy). A win-win for everyone..

j chipchase

06/12/14

I have been using CPAP for 3.5 years. It was identified after multiple PEs , 4 months post surgery. I find the full
face mask bulky and disturbing at night and quite often the seal whistles and disturbs my sleep. The nose prongs
are not suitable for my level of obstruction which is most frustrating. Nor can I sleep on my back because of the
level of obstruction. Not easy when the bilateral glut Medius muscles are tearing from the greater trochanter and
the iliac bone. A very painful condition to sleep on. After 2 rounds of multiple PEs I never want to go through it
again.
My respiratory physician also recommended it for times during the day when I feel as though I am being strangled:
laryngeal spasm which is apparently associated with my allergy related asthma.
I always take it into hospital when admitted. Anesthetists are keen for me to have it in the recovery room. At one
hospital the nurses attached an oxygen line to the air intake line to boost my blood oxygen levels.
My biggest problem in hospitals is that staff do not know how to care for the unit or fill the humidifier to the right
level. On more than one occasion I have had water blowing I to my airways because the humidifier was too full.
Wakes me up every time feeling as though I am drowning.
So far it has not helped with my obesity. I am trapped in a painful lifestyle from multiple autoimmune diseases and
their multiple complications. Walking is extremely painful, even with a walking frame.
Thanks to the Cpap I can now wake in the morning or whenever without an anoxic headache..

Dr.Dubrawsky

06/12/14

What is the purpose of CPAP use? To force more air down the tubes!
Why is the air inhaled, does not get down the tubes? Because the
tubes in the inlet, in the hypopharnx collapses in obese people.
Why don't it contract and open upon inhalation? Because of hypoxia!
Can't we make it open up?Yes,if we can supply more oxygen locally.
Is there a way to supply more oxygen locally when needed? Yes. By
cannula. Is that practical? Yes and no.What else can we do? Supply
then, with oxygen concentrator, Is that practical?Yes and no.Any
other option?Maybe.
Have these people take niacin-nicotinic acid 100 mg.(Vitamin B-3)
Sublingual at bedtime-after a meal of a cracker. What will happen?
You will sleep the perfect sleep. You won't snorr.You will not
experience Hypoxia Why? Because the Niacin's HDL molecule is built
with a molecular sieve in it.This is a NATURAL OXYGENE CONCENTRATOR
!!!
The individual involved carries trillions upon trillions of oxygen
concentrators, How much do you have to pay, to rent one oxygen
concentrator?How long does it take you to install?
My friend who take niacin, are slowly getting rid of the C-PAP
(Always under the supervision of their personal physician.).

sp,fnp

06/12/14

OSA causes obesity? There are people who are obese without OSA, and
there are non-obese patients with OSA..

dorothygreen

06/14/14

The Wahls diet, developed by Dr Terry Wahls is an optimal nutrition diet
using Paleo principles and functional medicine. The base is 9 cups of 3
categories of vegetables/berries, protein from grass fed meat and wild
fish, fermented foods and good fats like coconut,olive oil and of course
the fat from the naturally raised meat and fish.
So many people could benefit from this way of eating. It should be the
National diet. The world diet. It's possible.
I urge Dr. Gupta, the President of the AHA, Dr. Ornish and anyone who
really is interested in the healing of America to read The Wahls Protocol.
It is a game changer and you all might want to consider jumping on this
bandwagon. Info is coming out say from Harvard "all calories are not the
same". Coconut oil, ghea and fat from pasture animals is good.
Dr Wahls has worked out that the nutrients in 9 cups - 3 categories of
vegetables/colored fruit along with the protein and fat provide many times
more nutrients and phytochemicals than any other diet.
Well, anyway this study is rather meaningless. It seems like it is just
recycled from the late 1990s/early 2000s. CPAP has been around a long time
, just like sleep apnea and obesity. So, try a new approach CPAP and the
Wahls protocol. If I had any money I would bet it would make very
significant improvements..

DOJustin Hamlin

06/14/14

NURSE sp: Yes, OSA and other sleep
disorders CAUSE obesity. Obesity is merely
a symptom. Your statement means nothing.
"There are people who are obese without
OSA," So? Point to where I said that OSA
is the only cause of obesity. Your logic
fails. Other sleep disorders can also
cause obesity. Stress cause the obesity
and sleep disorders. Point is that diet
doesn't cause obesity and obesity doesn't
cause any medical problems, despite the
mantra you were taught to chant. "there
are non-obese patients with OSA." Again:
So? That just means they're not obese YET.
This statement actually is what disproves
the "obesity causes OSA" mantra. Again
your logic fails..

herbert gladen, md

06/14/14

dorothygreen: Before "jumping on the bandwagon" for any particular
diet or medical treatment of obesity, we need good long-term
controlled studies. Unfortunately, so far, the only proven really
successful long-term treatment of obesity is surgery. Of those who
successfully lose significant weight with diet or other medical
means, about 1/3 regain within a year and over 90% regain their loss
by 5 years. DOJustin Hamlin: While "association is not causation"
and we don't have controlled trials in which obesity is produced in
a random selection of individuals to compare to a control group,
most doctors would agree at least obesity-hypoventilation syndrome
and osteoarthritis of weight-bearing joints may be CAUSED by
obesity..

DrNoSA

06/17/14

OSA results in repeated bouts of hypoxemia, triggering sympathetic stimulation and surges of adrenal hormones
including cortisol which causes weight gain. Untreated OSA is responsible for the obesity epidemic. The majority of
the obese children and adults today have untreated OSA. Treatment with CPAP, diet and exercise is the solution..

M. McNamara MD

06/18/14

some excellent
comments.
I want to add that
one should remember
that putting oxygen
on an obese,
hypoventilating
person who is
already retaining
CO2 is dangerous. It
can further suppress
respiratory drive,
increase CO2 further
and things can get
pretty nasty..

cb md

07/17/14

Allow me to begin
by stating that I
agree that OSA can
be an important
causative factor in
obesity, in some
cases. Several
comments seemed to
state that it is
the only factor.
There are a few
absolute statements
that are always
true. If OSA is
because of the
obesity epidemic,
then why does the
obesity epidemic
correlate well with
economic
development and
rise in disposable
income in many
countries around
the globe. I have
seen some patients,
admittedly a small
percentage, who
have a normal or
low BMI, but yet
had significant
OSA. I would think
that many patients
have a
multifactorial pre-
disposition to
develop OSA, and a
vicious cycle is
set in motion by
weight gain..

This survey is a poll of those who choose to participate and are, therefore, not valid statistical samples, but rather a snapshot of what your colleagues are thinking.

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